Hyper-reflective subretinal infiltrates visible on spectral domain optical coherence tomography (SD-OCT) could help diagnose primary vitreoretinal lymphoma (PVRL), researchers believe. The finding could lead to earlier diagnosis of the rare disease; wrote Dr Robert J. Barry from the University of Birmingham, Birmingham, UK, and colleagues in the British Journal of Ophthalmology . “It is hoped that increased awareness of characteristic OCT findings in PVRL may improve patient outcomes in this life-limiting disease,” they said. Most often an extranodal presentation of non-Hodgkin's lymphoma, PVRL can be hard to diagnose. It only turns up in 0.01% of all ocular diagnoses, so ...

Optical coherence tomography angiography (OCTA) is a new imaging technique that has the potential to move rapidly into routine clinical practice. OCTA comprises different OCT-based technologies, which enable the non-invasive assessment of retinal perfusion, based on red blood cell movement in the optic nerve head, the peripapillary and the macular retina. In addition to the benefits offered by the non-invasive nature of OCTA over invasive fluorescein angiography in macular diseases, including age-related macular degeneration and diabetic macula oedema, OCTA has been increasingly investigated for use in the detection of glaucoma and understanding the role of vascular alterations in the development ...

Optical coherence tomography angiography (OCTA) is a new imaging technique that has the potential to move rapidly into routine clinical practice. OCTA comprises different OCT-based technologies, which enable the non-invasive assessment of retinal perfusion, based on red blood cell movement in the optic nerve head, the peripapillary and the macular retina. In addition to the benefits offered by the non-invasive nature of OCTA over invasive fluorescein angiography in macular diseases, including age-related macular degeneration and diabetic macula oedema, OCTA has been increasingly investigated for use in the detection of glaucoma and understanding the role of vascular alterations in the development ...

Ophthalmologists could have a new tool to assess progression in glaucoma by measuring vascular damage in the retina and optical nerve head. Optical coherence tomography angiography (OCTA) can directly measure retinal vessel densities in a non-invasive, reliable, and reproducible manner, and provide indirect measurements of ocular perfusion and blood flow. “We know that retinal blood flow is reduced with increasing glaucoma severity,” said Vikas Chopra, MD. “We have not had an easily performed, reliable, noninvasive method to assess retinal blood flow or changes in retinal blood flow before OCTA,” said Dr. Chopra, associate professor of clinical ophthalmology, David Geffen School ...

Wide-field retinal imaging can be performed using a commercially available swept-source optical coherence tomography (SS-OCT) platform (DRI OCT Triton, Topcon) and only the internal fixation light for patient navigation provided detailed images of both normal and pathologic peripheral retinal findings. “In 2016, we published a paper describing our experience with ultra-widefield Spectral-Domain OCT (SD-OCT) using a system with a 30° steerable lens (Spectralis, Heidelberg Engineering) [ Ophthalmology . 2016;123(6):1368-74],” said Netan Choudhry, MD, founder and medical director, Vitreous Retina Macula Specialists of Toronto, Canada. “Recognizing that not all clinicians have access to that device, as a next step we ...

iagnostic technology in pediatric neuro-ophthalmology has made tremendous advances in the past 25 years, according to R. Michael Siatkowski, MD. “We’re close to an easy-to-use, handheld optical coherence tomography (OCT) device for the operating room, but it still needs to be cheaper, lighter, and able to adapt to eye changes in the first 3 years of life,” said Dr. Siatkowski, the David W. Parke II, MD Professor; vice chairman for academic affairs, and residency program director, Dean McGee Eye Institute, University of Oklahoma, Oklahoma City. “It also has to have higher-quality analytics,” he added. “You don’t want to ...

No doubt the commercialization of optical coherence tomography (OCT) has forever changed the clinical management of retinal disorders. Its introduction into the surgical realm may be a game changer in its own right, said Pravin U. Dugel, MD. Modern microscopes limit the surgeon’s view, and “axial information must be inferred from instrument shadowing and other indirect cues.” 1 As advances in OCT technology have increased the ability of these devices to image ocular structures better, the category as a whole has moved into a wide variety of applications, including the ability to assess subretinal fluid, pigment epithelial detachments, and ...

No doubt the commercialization of optical coherence tomography (OCT) has forever changed the clinical management of retinal disorders. Its introduction into the surgical realm may be a game changer in its own right, said Pravin U. Dugel, MD. Modern microscopes limit the surgeon’s view, and “axial information must be inferred from instrument shadowing and other indirect cues.” 1 As advances in OCT technology have increased the ability of these devices to image ocular structures better, the category as a whole has moved into a wide variety of applications, including the ability to assess subretinal fluid, pigment epithelial detachments, and ...

This has been the year of optical coherence tomography (OCT) angiography, numerous retina specialists said. Commercially available systems are available from Carl Zeiss Meditec, Heidelberg Engineering, and Optovue provide a noninvasive way to image retinal vasculature and confirm clinicians’ diagnoses of abnormalities. “Imaging continually changes; every year it’s being used a little bit differently,” said Julia A. Haller, MD, ophthalmologist-in-chief, Wills Eye Hospital, Philadelphia. 2016 was just the cusp of OCT angiography, said Charles Wykoff, MD, PhD, Retina Consultants of Houston, and deputy-chair of ophthalmology, Houston Methodist Hospital. “We’re starting to see a lot of podium time being ...

In 1991, David Huang, MD, PhD, of the Massachusetts Institute of Technology described the first use of optical coherence tomography (OCT) for noninvasive cross-sectional imaging in biological systems. When the first commercial time-domain OCT (TD-OCT) debuted 5 years later, it was able to acquire data at a rate of only 100 axial scans per second. Six years later, this speed had quadrupled to 400 axial scans per second. As improvements in speed and quality persisted, OCT became the gold standard for diagnosis of glaucoma and many retinal diseases such as age-related macular degeneration and diabetic eye disease. OCT is based ...

Measures of structure and function change can help ophthalmologists individualize treatment of glaucoma patients, according to Robert Chang, MD, assistant professor of ophthalmology, Stanford University. Since glaucoma progresses faster in some patients than others, optical coherence tomography (OCT) and visual field progression analysis can be more useful than IOP in guiding treatment decisions, said Dr. Chang during the Glaucoma Symposium CME at the 2016 Glaucoma 360 meeting. “I use structure and function glaucoma progression analysis to really customize therapy over a lifetime,” he said. “That’s my method of precision medicine in treating glaucoma patients today.” Concept precision medicine has ...

En face o ptical coherence tomography (OCT) is a valuable imaging strategy for anatomic and angiographic viewing of the fundus. The technology is useful for diagnosing and monitoring diseases with layer-specific anatomic abnormalities or microvascular flow alterations, said Philip J. Rosenfeld, MD, PhD. “The real advantage of en face OCT is the ability to slice and dice the images throughout their entire depth, from the choroid to the vitreous,” said Dr. Rosenfeld, professor of ophthalmology, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami. “ En face OCT imaging became clinically useful with the advent of high-speed, high-density ...

Progress in posterior segment optical coherence tomography (OCT) imaging is continuing with novel software that provides better correction for eye motion, as well as new technology which offers faster imaging speeds, said James Fujimoto, PhD. These developments will enable advanced processing and quantitative assessment of three-dimensional OCT data that—in the not-too-distant future—will bring functional imaging of blood flow and vascular structure into the hands of clinicians, said Dr. Fujimoto, professor of electrical engineering and computer science, Massachusetts Institute of Technology, Cambridge, MA. “We are now approaching a point with OCT where ophthalmologists have a view of the retina ...

Atlanta—The clinician remains the most important "diagnostic imager," and the clinical exam is the foundation of ophthalmologists' decision-making related to the diagnosis and treatment of glaucoma, Douglas J. Rhee, MD, told those attending the Spotlight on Glaucoma session at the American Academy of Ophthalmology annual meeting. His talk was designed to serve as a counterpoint to the previous presentation highlighting the benefits of technology.

The newest version of proprietary software (Guided Progression Analysis, Carl Zeiss Meditec) to measure the functional progression of glaucoma combines event and trend analyses and enables faster, more quantitative evaluation of change in visual field than that permitted by older methods, according to one ophthalmologist. Use of the software requires a particular, newer perimeter (Humphrey Field Analyzer II-i, Carl Zeiss Meditec), and clinical correlation is advised.

San Francisco—Intraoperative subtraction pachymetry may be less accurate and more prone to measurement error than postoperative optical coherence tomography (OCT) measurements, according to Yohko Murakami, MA, Stanford University School of Medicine, Stanford, CA. Murakami presented information on a prospective, randomized trial in which 100 eyes of 50 consecutive patients were treated for myopia using custom wavefront-guided LASIK. In each patient, one eye was treated with a femtosecond laser and the other eye was treated with a mechanical microkeratome. Patients were followed for a year.

Major advances in technology have given birth to state-of-the-art imaging devices that decisively raise the bar in diagnostics in ophthalmology today, according to Jeffrey S. Heier, MD, speaking at the annual meeting of the American Academy of Ophthalmology.
According to Dr. Heier, a vitreoretinal surgeon at Ophthalmic Consultants of Boston, specific spectral-domain optical coherence tomography (SD-OCT) technology (Spectralis, Heidelberg Engineering) is leading the way in this retinal revolution, redefining not only how ophthalmologists diagnose diseases but also how they manage them.

Paramus, NJ—Topcon Medical Systems has received FDA clearance for its enhanced 3D optical coherence tomography (OCT) measurement software (OCT-1000 TrueMap) as an addition to its previously cleared OCT system (3D OCT-1000), according to a prepared statement. The software, according to the company, is designed to allow physicians to visualize four layers of the retina: the inner limiting membrane, the IS/OS junction, the retinal pigment epithelium, and Bruch’s membrane. The software also can import and read data from a time-domain OCT device (Stratus, Carl Zeiss Meditec).

As understanding of the multifaceted nature of glaucoma continues to grow, the steps practitioners
need to take to monitor progression of the disease evolve. Key steps to take to monitor progression include
confirming with repeat testing any visual function loss, remembering that structural measurements have variability,
and using structural and functional testing together.